If the thought of hospitals conjures up images of sterile white hallways and cheap vinyl furniture, think again. Today's medical facilities are anything but boring, with evidence-based design bringing the outdoors in ... and conveniences of the indoors out.

Natural Beauty

Alana Morris, IIDA, NICIDQ, EDAC

"When it comes to healthcare interiors, we're really seeing a lot of biophilic design, which is using materials that mimic elements found in nature," said Alana Morris, IIDA, NICIDQ, EDAC, senior interior design manager for architectural firm ESa (Earl Swensson Associates). The Nashville firm is a national leader in healthcare construction and design, with in- and outpatient projects underway coast to coast.

Green products are also on the top of today's client lists, with moss-like carpet and living walls -- panels of plants, grown vertically using hydroponics -- popping up in medical centers nationwide. "Bringing nature into an environment creates a calming space for patients as well as caregivers, and we're incorporating that across the design of our buildings," Morris said.

It's a far cry from the generic, mass-produced artwork that once lined hospital walls, but experts say it's a valuable change rooted in evidence-based design. "Bringing these elements indoors has been shown to improve patient outcomes, similar to how we now know incorporating windows and natural light into patient rooms increases a person's chance of getting better," Morris said.

Designers also are seeing increased demand for hospitality style decor, which incorporates higher end design elements not traditionally found in hospitals. Glass mosaic wall tiles and custom digital imagery printed on cleanable resin are top choices for many facilities. "It's a way to have that 'wow' factor in your project and engage in your environment," said Morris, noting the popularity of natural landscapes and large-scale artwork in various mediums.

A Fresh Take on Hospitals

Jill Romano

Construction design is evolving as well, as administrators re-envision the role of the hospital. "A lot of clients are now looking at hospitals as wellness centers for the entire community instead of a place where sick people are cared for," said architect Jill Romano, AIA, project manager for ESa's healthcare division. "We're designing around the idea of community interaction, from walking trails to showers, terraces, outdoor dining spaces and courtyards designed to bring the outside in."

Similarly, Romano said micro hospitals are the new buzzword in hospital design. "We're seeing a new, robust outpatient component and integration of physician offices on the same campus, as opposed to building a bigger hospital," she said. "It enforces that focus on wellness and reflects the push toward fewer inpatient stays that hospitals are trying to achieve."

While the need for inpatient beds will never go away, consolidation of health systems nationwide has led to frequent centralization of shared services rather than operating all departments (such as laundry and central processing) on all campuses.

Doctor-Friendly Designs

Today's healthcare facilities also reflect an increased focus on physicians, who now play an integral role in the planning process. "It's typical to have quite a few meetings with the end users who will be working in the space, and those conversations continue throughout construction," Romano said. "There's a big push for hospital owners to get staff buy-in early on."

She continued, "Employers want to create a nice workplace experience, from trails for those who want to bike to work to staff oasis rooms where a physician can focus and regroup before extremely tough cases. There's a new focus on recognizing that this is a high-stress job and providing areas of respite for clinicians."

Sustainability as a Standard

There's no question expectations are shifting in healthcare design, and environmental impact is no exception. Once considered a sign of going 'above and beyond,' Leadership in Energy and Environmental Design (LEED) certification is now becoming a national standard in healthcare construction. The rating system devised by the United States Green Building Council evaluates the environmental performance of a building and encourages market transformation towards sustainable design.

"As building codes evolve, some things that used to be exceptional are becoming the norm," Romano said. "Hospital owners now recognize that they can be sustainable without the fees associated with LEED certification."

Easy Fixes, Big Results

While not every employer can afford a complete design overhaul, experts say there are small steps organizations can take to create a healthier, more sustainable environment. Switching to LED fixtures can produce tremendous savings for a 24/7 medical center, while safer, low-VOC materials are now equally as effective as their higher risk counterparts. Clients also are paying attention to the "red list" of chemicals they want to avoid, including those applied to the tops of surfaces - hence the riddance of vinyl and PVC in countless waiting rooms.

A New View

Another remarkable shift in design planning is the role of virtual reality. Once used to produce a single design image, virtual reality is now instrumental in developing entire facilities users can explore room by room, with some clients even trading traditional building models for virtual reality goggles.

While possibilities in healthcare design are endless, Romano said it could be challenging for clients to keep an open mind. "For architectural planning, there are so many times when people are stuck in the mindset of what they've always done," she said. "It's all about challenging them to find the best solution for their workflow."